Provider Demographics
NPI:1508295023
Name:JAN, IRUM ZEB (MD)
Entity Type:Individual
Prefix:DR
First Name:IRUM
Middle Name:ZEB
Last Name:JAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 GIBSON BLVD SE
Mailing Address - Street 2:APT # 1106
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-3348
Mailing Address - Country:US
Mailing Address - Phone:505-400-0482
Mailing Address - Fax:
Practice Address - Street 1:1801 GIBSON BLVD SE
Practice Address - Street 2:APT # 1106
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-3348
Practice Address - Country:US
Practice Address - Phone:505-400-0482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRS2013-0902207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine